Revenue Cycle Specialist

About the role

The Revenue Cycle Specialist ensures Medicaid policies and procedures are followed across all Arrow services, directly impacting services to children, families, and compliance. This position handles accurate billing and collection of Medicaid claims, denial management, and reporting denial trends to internal stakeholders.

Responsibilities

• Confirm patient insurance eligibility, assign medical codes (CPT/ICD-10), and prepare/submit claims to third-party payers.
• Communicate with internal stakeholders to address billing questions and concerns.
• Review and submit insurance claims accurately, ensuring compliance with payer requirements and coding standards.
• Track and follow up on unpaid claims, resolving denials and rejections with payers within deadlines.
• Prepare and submit letters of appeal for denied claims, including all required documentation.
• Monitor aging reports, track outstanding balances, and minimize payment delays.
• Maintain up-to-date knowledge of industry regulations, payer policies, and coding changes.
• Ensure compliance with state, federal, and HIPAA regulations, as well as Arrow policies, NCASES, and COA standards.
• Perform duties within contract, state, and federal regulations.
• May be required to drive vehicles, meet auto insurance provider requirements, and complete company vehicle training.
• Occasional travel may be required.
• Other duties may be assigned as necessary.

Requirements

• Bachelor’s degree in human services, business, finance, statistics, or related field (master’s degree preferred).
• Minimum of five (5) years of relevant experience in revenue cycle operations, including billing, coding, reimbursement, data analysis, and risk management.
• Child welfare experience is ideal.

Benefits

• Medical, dental, and vision insurance options, including HSA match for qualifying contributions.
• Parental paid leave.
• Retirement savings plan with company match.
• Paid time off and holiday pay.
• Mileage reimbursement.
• Tuition reimbursement available.
• Company-sponsored learning and development.